Psychopathy has become a topic of great interest to moral philosophers in the last decade, not just because it is interesting to debate whether psychopaths can be held morally responsible for their harmful actions, but also because it serves as a crucial test case in meta-ethical debates. There is an old controversy about whether being morally competent is a matter of understanding moral rules (rationalism) or having appropriate moral feelings (sentimentalism). If one is morally competent, then one can be held morally responsible for one's actions. A common understanding of psychopaths is that they lack a conscience, but it is not so clear how to spell out what that means. It is clear that psychopaths tend not to accept responsibility for their harmful actions, but rationalize them. They know perfectly well that other people believe in moral rules, but they don't have any particular respect for those rules or for other people. They also are impulsive and are bad at planning out their futures, so they often do things that get them into trouble. People who talk to them report that they have a very shallow understanding of morality, which consists in little more than being able to parrot back the words they are given. They show no sign of understanding the pain and suffering they cause, although they seem close to normal abilities in being able to tell what other people are feeling. But not all psychopaths are the same, and there's debate as what the criteria of being a psychopath should be, although Hare's psychopathy checklist has become pretty definitive. So are psychopaths best described as lacking the ability to do moral reasoning, or lacking appropriate moral emotions, or both? What implications are there for whether we should morally blame them for the harm they cause to others? Can they provide evidence for moral rationalism or moral sentimentalism?

These are some of the main questions addressed in this admirable collection put together by Luca Malatesti and John McMillan. The first two parts address the law and psychology respectively, while the third, longer part, addresses philosophical issues. Tony Ward gives a useful historical perspective on the treatment of psychopathy in the UK law, while Peter Bartlett covers the current situation. Stephen Morse describes the place of psychopathy in USA law, in a rich philosophically-informed chapter. Matt Matravers finishes the section on law with a paper arguing that defenders of existing approaches in the law may need to rethink their ideas of punishment because psychopaths do not choose their condition, but end up as they are due to being unlucky either with their childhood circumstances and/or their genetic inheritance. But his paper ignores most of the philosophical debate on responsibility, and in particular, does not address the obvious response that it may be a matter of moral luck whether we are good people or bad people, but that does not undermine the practice of blaming people for bad actions (pace recent arguments of Neil Levy).

The second section stands out for its difference. The book editors contribute a chapter on whether Hare's psychopathy checklist PCL-R is a useful classification. There is a reprint of a 2009 article by Hare and Neumann on assessment of psychopathy and its forensic implications, which sets out many recent findings and cautions against being too enthusiastic about the use neuroscience to understand psychopathy, and points out there are many controversies with the legal responsibility of psychopaths. Harenski, Hare and Kiehl go into some detail about neuroscience and psychopathy, and again caution about the limits of knowledge. Finally Ogloff and Wood discuss treatment options for psychopaths and argues that while not all treatments do any good, it is a myth that psychopaths are untreatable. It is a detailed paper with what looks like plenty of good recommendations. Only those well versed in the relevant literature will be in a position to really assess the chapter.

The heart of the book lies in the third section, addressing mainly philosophical issues. It features many of the most influential writers in the area, and their papers include discussion of much of the recent literature, so this will be a valuable resource for both philosophers who are already familiar with the discussion and those who want to learn about the debates. Not all of the seven main papers in this section will be equally interesting to readers, but they reflect a variety of perspectives and the quality of writing is strong. The editors' introduction to the section is also useful.

The majority of contributors here argue that psychopaths are either not morally responsible or else have greatly diminished moral responsibility. But they have a variety of arguments for this conclusion. Anthony Duff comes first. He makes the important distinction between excuses and exemptions: people who have excuses are morally responsible for what they do but we reduce punishment or don't punish at all. People who are exempt are not morally responsible at all, and so should not be blamed at all for their actions. We might still incarcerate people if we think they are dangerous, but this would be preventative rather than a form of blaming punishment. Standardly, we would say that someone who stole property because they were being blackmailed had an excuse (to some degree) but were still morally responsible. On the other hand, standardly we would say that someone who steals because they believe they have received orders from God to do so is delusional, and so is exempt from moral blame. Duff argues that there is no sharp distinction between cognitive disorders leading to delusions and emotional disorders that lead a person to behave in antisocial ways due to emotional abnormalities. He gives the example of Peter, who is so pathologically depressed that he thinks that life is completely worthless, and so he kills his family and attempts to kill himself. Duff argues that Peter is not answerable for his killing because his depression is so severe, in virtue of being pathological, that we cannot discuss reasonably with Peter whether he had good reason for his action. Duff goes on to argue that psychopaths display a similar rational deficiency and so are not morally responsible for their crimes. In particular, Duff argues that psychopaths cannot understand morality, understanding morality is essential for being morally responsible. While he gives a little detail, he largely ignores much of the recent discussion about what it means to understand morality, and so the paper is better as an introduction to the topic rather than as an extension of the current debate about it.

Grant Gillett in his paper analyses psychopathy not as a disorder of understanding at all, but rather one of volition. On his view, which seems based on cases from a 1976 work of Cleckley, psychopaths can have a perfectly good understanding of what they are doing wrong, but they fail to act on that understanding. Gillett's approach is idiosyncratic: he develops a Nietzschean theory of action that emphasizes the will to power. His analysis of psychopaths is that their character is schizoid. His conclusion is that this should alter our moral response to a psychopath, although he does not spell out any practical consequences of his view. This is a remarkable paper, drawing both on scientific literature, the work of Sartre, Nietzsche, Foucault, Lacan, Gillett himself, and several contemporary philosophers. While it is rich in its supply of ideas, it is hard to relate to the other papers in the collection, and so it stands out on its own.

De Sousa and Heinrichs ask "Will a stroke of neuroscience ever eradicate evil?" in their paper title. It's a curious title, because the answer is "obviously not," however one parses the question. The real topic of the paper is the relation between our ideas of morality and neuroscientific explanations of human behavior, with particular attention paid to a case example of a woman whose husband was killed by a psychopath and who wanted to make a witness-impact statement at the sentencing phase of the trial. The authors of course raise the question whether the psychopath is really to blame morally for his crime. Their claim is that we need to dispense with old ideas of free will and evil, and move towards a new conception of assessing people's behavior. This cannot be done in exclusively scientific terms, but they hold that it needs to be done in more coherent philosophical terms. The authors do not go very far in saying what the new approach should be, but they point to the Darwinian notion of function, the ways in which conscious deliberation seem epiphenomenal, and ways of understanding when an action represents a person. They draw a distinction between a person with Tourette syndrome and a psychopath: the attitudes of the psychopath come from his or her "central processing capacities." They finish their paper with a discussion of the importance of the moral community in forming our moral lives. Their comments are a little cryptic, but they seem to argue that victim impact statements in trials can be worthwhile in helping individuals to flourish.

The remaining four papers are by philosophers with distinct claims to make about the moral responsibility of psychopaths. Levy, Kennett and Haji argue that psychopaths do not quality for full moral responsibility, while Maibom argues that they can. But there are disagreements and differences in approach between the first three authors, while there are areas of agreement between Maibom and the others.

Levy pays special attention to the psychological research on psychopaths. He argues that certain kinds of affective responses are necessary in order to become morally competent, and psychopaths lack those responses. His argument has many elements, and I won't repeat them all here. Centrally, he argues that our morality is the product of evolution, and this gives most people the ability to have normal moral responses. While psychopaths are able to say what moral rules people have, they are not able to distinguish moral rules from conventional rules. Levy defends his view against some objections, and provides more evidence for how psychopaths have deficits in general reasoning ability. It is a powerful case, and if it going to be criticized, then one either has to show that Levy has made empirical mistakes about the deficits of psychopaths, or else one has to make a conceptual case that his is mistaken about what it takes to be morally responsible. The evidence is bound to be messy and the interpretation of experiments can be disputed. For one thing, one might well agree that psychopaths have a shallow understanding of morality, but this is different from saying that even those with the most severe psychopathy have no understanding of it at all. It is hard to separate out the empirical and conceptual issues, and some place very stringent requirements on what it is to be a moral person, which leads to the question of what proportion of humans would qualify. Those of us who teach undergraduates on a regular basis may suspect that many of our students would not qualify as moral beings if we have demanding requirements. But given that Levy has elsewhere argued, in his 2011 book Hard Luck, that no one is morally responsible, he may be unworried about the problem of maintaining a clear and relevant distinction between psychopaths and the rest of us.

Kennett's approach is more consensus building; she argues that different players in the debate have been arguing past each other, and in fact they should be able to agree on the moral incapability of psychopaths. She examines what it means to make a moral judgment. She points out that one can view morality from an anthropological point of view, and thus know what other people's moral beliefs are, without having moral beliefs oneself. Do psychopaths themselves make judgments such as "needless violence is wrong"? She highlights the relevance of the debate between moral externalists and internatlists: the externalist says that one can have a moral belief about what is wrong, and yet not be moved to act on it, while the internalist holds this to be impossible, except possibly in cases of weakness or exhaustion. So the internalist would say that psychopaths could not make moral judgments and fail to be moved by them, while the externalist would say psychopaths could make moral judgments and simply not act on them (as Gillett seemed to be saying).

Kennett points out that with these different theories, it will be easy for sentimentalists and rationalists to talk past each other. Nevertheless, she says that they can (and do) agree that psychopaths don't make (and are unable to make) moral judgments. This is a rather surprising claim on her part, since there are some philosophers who hold that psychopaths are indeed morally responsible for their actions. She argues for her claim using Karen Jones's criterion of competence with a concept: one has to be "conversable" with the relevant terms. As Kennett explains it, the idea is that one should be able to recognize blatant inconsistencies between what one says and what one does. She then goes on to give examples of psychopaths such as the murderer who said the he had taught his victim "a hard lesson about life" and so had benefitted her. Kennett also cites some more scientific evidence that psychopaths are less likely to be consistent in their moral statements than other people are. She also cites similar evidence as Levy about the difficulty that psychopaths have in grasping the distinction between moral rules and conventional rules. In the main text, Kennett concludes that psychopaths fail the conversability test, although in footnote #2 she concedes that this may oversimplify, but still she downplays the problem. Just being poor performers in a test does not mean that people fail it: many students make major mistakes in tests but still pass them. Given then we have no absolute test of what counts as moral competence, it seems that most we can say is that psychopaths have a shakier understanding of morality than the rest of us, not that they fail in competence. Who is to say what counts as failure? Indeed, psychopaths have some understanding of morality, just as an anthropologist has some understanding of a culture he or she does not share. So Kennett's arguments here do not make a strong case for her conclusion.

Kennett spends the rest of her paper arguing that there cannot be an absolute split between sentimentalists and rationalists, and in particular, sentimentalists must allow that rationality and reasons responsiveness is part of being a moral person, while at the same time conceding that rationalists can agree on the importance of emotions in our moral life. She argues that the psychopath has both a lack of empathetic feelings for others and a lack of responsivity to moral reasons, that these are probably related to each other, and this is enough to show that psychopaths don't count as moral agents.

Her discussion of the common ground between sentimentalism and rationalism may well be right, and it is a helpful contribution to the discussion. Still, this does not make Kennett's prior conclusion that psychopaths lack moral responsibility to a major extent any more convincing to those who believe the opposite. So we can move to Haji's arguments, which are quite different, yet equally debatable.

Haji starts out briefly mentioning an argument he has given elsewhere (he does not say where) against Walter Glannon, who put forward the view that psychopaths are partially responsible for their actions. Haji says that if a person is reactively dead to moral reasons, then the psychopath lacks freedom of action, and so does not meet the requirements to be responsible for actions at all. This is a puzzling comment to make, and he does not expand on it. It is hard to see why lacking the capacity to genuinely care for others or care about their suffering takes away one's freedom or self-control. But this is Haji's view, and his later comments explain the idea further. He summarizes the arguments by Levy and Fine and Kennett in previous publications to the effect that psychopaths lack moral responsibility, and he then cites criticisms of those views in a paper by Vargas and Nichols in 2007. He further cites some reservations about assuming that violating moral norms is necessarily worse than violating other norms, citing a chapter of his 2008 book co-written with Cuypers. So he provides his own distinctive argument for the same conclusion, that psychopaths are not culpable for their actions. His approach is to argue that in order to be responsible for an action, it must be authentic, and that due to their condition, the actions of psychopaths are not authentic.

Haji explains that it is global manipulation cases that fuel the plausibility of an authenticity requirement, where one person secretly and successfully (in a science fiction) is able to control what another person is motivated to do. He has developed his theory in detail in recent years, and here he briefly summarizes it. For our purposes, a crucial element is that children must develop their evaluative schemes in a proper way. A person's scheme will evolve as a person goes through life, and so long as each step in the evolution proceeds in an acceptable way, the scheme will remain authentic. However, if there is inappropriate interference in the development, it will become inauthentic. If children are raised deliberately in a way that they lack central moral knowledge, then this undermines their responsibility for their actions. If a child Simon is raised to always act impulsively rather than to take a long-term view of his goals, then we would not hold Simon responsible for his later impulsive behavior. If Simon were raised deliberately in a way that he is unable to reflect on his own behavior and inspect his own values, again he lacks moral responsibility for his actions. This may be plausible, although not all would agree. However, Haji goes on to assimilate this to cases where a person becomes a psychopath due to a combination of bad childhood and genetic influences, where there is no deliberate attempt to mold the child's character; it is just an unfortunate consequence of circumstances. These are different sorts of cases and our intuitions will be less strong in this latter sort of case. This is especially important since Haji is trading on intuitions about authenticity. If my desires and values are manipulated by someone else, then it makes sense to say they are not authentic. If my desires and values are a result of unfortunate circumstances, with no deliberate manipulation by others, if it far less plausible to say they are inauthentic, even if I would have had different desires and values if I had a different childhood and different genetic traits. We are inclined to say they really are my desires and values, however unfortunate that may be.

Of course, if someone has an impaired set of abilities to think about morality and empathize with others, that may well be a reason for believing them to be less responsible for their harmful actions, but the reasons would be the sort that Levy and Kennett have spelled out. Bringing authenticity into the debate sheds no further light on the issue; rather it conflates psychopathy with fundamentally different kinds of cases. Bringing in issues of authenticity might be helpful in cases of periodically recurrent mental illness, or possibly in cases of major dissociation. But psychopaths tend to be as consistent in their behavior as the rest of us, and (pace Gillett with his talk of psychopaths as schizoid) they don't seem to have major splits in their personalities or enter into altered states.

One issue that all authors on this topic have to address and that is of particular concern for Haji is the notion of degrees of responsibility. Haji criticizes Glannon for contemplating the possibility that psychopaths bear a degree of responsibility for their behavior, but then he goes on to advocate precisely the same thing. In our moral practice, we are not particularly good at assessing degrees of responsibility, even though of course it is forced onto people in the legal process in civil trials where damages may be awarded against one side, even when they have some excuse for their act of causing damage. In those cases, someone has to decide what proportion of the damages they are liable for. In these papers, authors very little indication of how to assess if psychopaths are morally responsible to a minor, medium or major extent. It would help if more papers followed the example of de Sousa and Heinrichs and addressed specific practical questions about what to do.

The view that psychopaths are morally responsible may be a common view in ordinary people, but as we have seen, it is probably a minority view among philosophers who have written on the topic. Maibom's 2008 paper, "The Mad, The Bad, and the Psychopath," argues for this minority view, and in it, she adopts a sentimentalist view. Her paper in this book covers similar ground, examining how much the case of the psychopath supports sentimentalism. While she agrees that a person's capacity for moral emotion and their ability to reason practically are closely tied, she argues that they are still separable. If a person's ability to reason practically is intact, then they should be able to act well, and avoid acts of violence that needlessly hurt other people. If morality is as rationalists say based on the ability to reason well, then those who reason well should then be moral. It will be a major problem for rationalism if it turns out that psychopaths are indeed able to reason well. Now it is clear that psychopaths have emotional disturbances, in their lack of empathy for the suffering for others, although they do have some capacity for empathy. They tend not to feel remorse, guilt, shame, sadness, love and fear. While Maibom is inclined to argue that these deficits explain the psychopath' s bad behavior, she admits that it is hard to pin down precisely which deficits are the most important.

Maibom considers the rationalist approach, that the psychopath's behavior is caused by a deficit in practical reasoning. She mentions a few different approaches to understanding psychopathy and then focuses on the view of Prinz set out in his 2007 The Emotional Construction of Morals. Her main point is that even Prinz, a sentimentalist, uses failures of practical reason to explain the behavior of psychopaths. So she is heading for a pessimistic conclusion that the case of psychopathy cannot help us decide between sentimentalism and rationalism. At the same time, the view she defends, on the close association of deficits in emotion and reason, is close to that defended by Kennett in her paper for this collection.

The book could have done with slightly more proof-reading. I found at least one case of an article referred to in the text but not listed in a bibliography, one case of an oddity with font sizes, and an so on. These sorts of problem were not major, but they were noticeable. It wasn't clear that the editors needed to add their several contributions to the book, although they were certainly not bad and they might be useful. Most readers will want to focus on those chapters that interest them most; it will be the rare reader who reader the whole book. Several papers in the third section represent important next steps in the philosophical debate over psychopathy, and most philosophers will want to focus on those.

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